A Case of Cervical Chondrocutaneous Branchial Remnant Comprised of Hyaline Cartilage

No abstract available.

Congenital Melanocytic Nevus with Secondary Cutaneous Mucinosis in a Child / 대한피부과학회지

No abstract available.

Validation of G-protein beta-3 subunit gene C825T polymorphism as predictor of obesogenic epidemics in overweight/obese Korean children / 한국영양학회지

PURPOSE: We investigated the potential interaction between the G-protein beta-3 subunit gene (GNB3) C825T polymorphism, a risk factor for chronic disease in various ethnicities, and obesogenic environments in overweight/obese Korean children. METHODS: The present study was conducted as a cross-sectional study using measures of anthropometry, blood pressure (BP), and fasting blood samples as well as 3-day food records. Subjects were recruited from seven elementary schools in an urban district in Seoul, South Korea, between 2007 and 2008. A total of 1,260 children aged 8-9 years were recruited in the study, including 633 boys (50.3%) and 627 girls (49.7%). RESULTS: The allele frequencies of the GNB3 polymorphism were C allele = 49.7% and T allele = 50.3% in subjects. In general, boys with T allele had higher BMI, systolic BP (SBP), and triglycerides, although their energy intake was not significantly different from boys with C allele. In contrast to boys, girls with T allele had lower BMI but higher SBP and energy intake than those with C allele. The girls with T allele had a significantly lower BMI and waist circumference in both the normal weight group and obese group (OB). T allele carriers in both genders had significantly higher TC than C allele carriers in the OB group. At last, girls with T allele in OB appeared to have significantly lower HOMA-IR than those with C allele. CONCLUSION: Unlike higher risk for negative health outcomes by the GNB3 polymorphism in various ethnicities, GNB3 polymorphism did not influence obesogenic environments in overweight/obese Korean children.

Impact of Clinical Performance Examination on Incoming Interns' Clinical Competency in Differential Diagnosis of Headache / 가정의학회지

BACKGROUND: In Korea, clinical performance examination (CPX) has been included in license examination for medical doctors since 2009 in order to improve clinical performance of medical students. This study aimed to evaluate the contribution of CPX to medical education. METHODS: Clinical competency in the differential diagnosis of secondary headache was compared between the incoming interns in 2009 unexposed to CPX and the incoming interns in 2010 exposed to CPX, using the data of patients who visited the emergency department due to headache (181 patients seen by 60 CPX non-exposed interns and 150 patients seen by 50 CPX-exposed interns). We obtained the data by reviewing electronic medical records and nominal lists of doctors. Clinical competency was assessed by sensitivity and specificity between the diagnostic impression by interns and the final diagnosis. The association between CPX exposure and clinical competency in secondary headache diagnosis was evaluated using multiple logistic regression analysis. RESULTS: When we assessed clinical competency on the basis of all listed diagnostic impressions, sensitivity and specificity were 67.9% and 80.0%, respectively, for headaches seen by CPX-exposed interns, and 51.7%, and 71.7%, respectively, for headaches seen by CPX non-exposed interns. Multivariable adjusted logistic regression analysis showed exposure to CPX was not associated with increased competency for identifying secondary headache. CONCLUSION: Exposure to CPX as a part of the medical license examination was not effective for the improvement of clinical competency of interns in identifying secondary headache.

Recovery effect of moxibustion at Nei Guan (PC-6) in xylazine induced bradycardia in dogs / 대한수의학회지

This study was performed to investigate the effect of Nei Guan (PC-6) moxibustion stimulation on artificial bradycardia of dogs. Xylazine was injected for inducing bradycardia. Rectal temperature, systolic blood pressure, respiratory rate, heart rate were recorded every 10 minutes for 120 minutes. Systolic blood pressure significantly increased on 40 min (p < 0.05) after xylazine injection, compared with those of control group. Heart rate significantly increased on 40 min (p < 0.01), 50 min (p < 0.01), 60 min (p < 0.01), 70 min (p < 0.01), 80 min (p < 0.01), 100 min (p < 0.01), 120min (p < 0.01) after xylazine injection, compared with those of control group. In conclusion, moxibustion of Nei Guan (PC-6) showed recovery effect in xylazine induced bradycardia in dogs.

Forensic Body Fluid Identification by Analysis of Multiple RNA Markers Using NanoString Technology

RNA analysis has become a reliable method of body fluid identification for forensic use. Previously, we developed a combination of four multiplex quantitative PCR (qRT-PCR) probes to discriminate four different body fluids (blood, semen, saliva, and vaginal secretion). While those makers successfully identified most body fluid samples, there were some cases of false positive and negative identification. To improve the accuracy of the identification further, we tried to use multiple markers per body fluid and adopted the NanoString nCounter system instead of a multiplex qRT-PCR system. After measuring tens of RNA markers, we evaluated the accuracy of each marker for body fluid identification. For body fluids, such as blood and semen, each body fluid-specific marker was accurate enough for perfect identification. However, for saliva and vaginal secretion, no single marker was perfect. Thus, we designed a logistic regression model with multiple markers for saliva and vaginal secretion and achieved almost perfect identification. In conclusion, the NanoString nCounter is an efficient platform for measuring multiple RNA markers per body fluid and will be useful for forensic RNA analysis.

A known expressed sequence tag, BM742401, is a potent lincRNA inhibiting cancer metastasis

Long intergenic non-coding RNAs (lincRNAs) have historically been ignored in cancer biology. However, thousands of lincRNAs have been identified in mammals using recently developed genomic tools, including microarray and high-throughput RNA sequencing (RNA-seq). Several of the lincRNAs identified have been well characterized for their functions in carcinogenesis. Here we performed RNA-seq experiments comparing gastric cancer with normal tissues to find differentially expressed transcripts in intergenic regions. By analyzing our own RNA-seq and public microarray data, we identified 31 transcripts, including a known expressed sequence tag, BM742401. BM742401 was downregulated in cancer, and its downregulation was associated with poor survival in gastric cancer patients. Ectopic overexpression of BM742401 inhibited metastasis-related phenotypes and decreased the concentration of extracellular MMP9. These results suggest that BM742401 is a potential lincRNA marker and therapeutic target.

Liver Abscess due to Gemella morbillorum in a Healthy Woman

Gemella morbillorum is a normal flora of the oral cavity, upper respiratory tract, gastrointestinal tract, or genitourinary system. Human infection cause by G. morbillorum is very rare. Known predisposing conditions are intravenous drug abuse, alcoholism, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, renal disease and poor oral hygiene. Most reported cases are infective endocarditis and vasculitis. We experienced a case of liver abscess by G. morbillorum in a healthy young woman, who was treated successfully with antibiotics and drainage. We report this case along with a literature review.

A Case of Pulmonary Embolism with Protein C, S Deficiency in Apical Hypertrophic Cardiomyopathy / 고신대학교의과대학학술지

Pulmonary embolism is caused by various conditions including genetic and acquired factors, and among them, C and S protein deficiency are known as a cause of pulmonary embolism although their incidences are low. Apical hypertrophic cardiomyopathy is known as a subtype of hypertrophic cardiomyopathies which was reported to be a cause of diastolic heart failure or thromboembolism by activating coagulation system, and this may have an effect on developing pulmonary embolism. We report this since we experienced a case of both C and S protein deficiencies in a patient with apical hypertrophic cardiomyopathy who was diagnosed as pulmonary embolism and has been examined to find the cause of the disease.

A Case of Prolonged QT Interval Association with Galantamine / 고신대학교의과대학학술지

Among the Acetylcholinesterase inhibitors as used for Alzheimer's disease treatment, Galantamine has been recently developed and widely used owing to proven its clinical efficacy and safety. However, it has reported that prolonged QT interval, which can lead to ventricular arrythimias such as Torsade de points, has developed in Galantamine-treated patients. A 74-year-old female Alzheimer's patient been treated with galantamine for 8 months visited the hospital complaining about frequent dizziness. ECG monitor was performed promptly, it was informed that the prolonged QTc interval was increased 450 ms to 486 ms. So, we made her stop taking the galantamine, and after that QTc interval has normalized to 406 ms. In this article, we reported the first case on prolonged QT interval associated with galantamine in Korea.

A Case of Angiotensin Converting Enzyme Inhibitor-Induced Systemic Lupus Erythematosus

Drug-induced lupus erythematosus is defined as a lupus-like syndrome related to continuous drug exposure which resolves after discontinuation of the offending drug. Here we report a case of a 70-year-old man who developed drug-induced lupus erythematosus after receiving angiotensin converting enzyme inhibitor medication for unstable angina pectoris, for 5 years. He was hospitalized with arthralgia, edema, and newly developed pleural effusion. The serum analysis revealed an elevated level of antinuclear antibody and antihistone antibody. After discontinuation of angiotensin converting enzyme inhibitor and receiving a course of prednisolone treatment, his symptoms and pleural effusion improved. To the best of our knowledge, this is, the first case report of angiotensin converting enzyme inhibitor-induced systemic lupus erythematosus in Korea.

A Case of Prostatic Abscess due to Burkholderia pseudomallei / 대한내과학회지

Melioidosis is an infectious disease caused by the Gram-negative bacillus, Burkholderia pseudomallei. It is endemic in Southeast Asia and northern Australia, where B. pseudomallei is a soil saprophyte and invades the host through inoculation, inhalation or ingestion. It infects mostly adults with predisposing conditions, mainly diabetes mellitus. The lung is the most commonly affected organ, presenting with either cough or fever resulting from a primary spread. Also, seeding and abscess formation can arise in any organ. However, prostatic abscess due to melioidosis is uncommon. We report a case of pneumonia, and prostate and scrotal abscesses due to Burkholderia pseudomallei, in a 48-year-old man with diabetes mellitus who had a history of working in Malaysia. This is the first report of genitourinary infection of melioidosis in Korea.

Identification of Novel Genes with Proapoptotic Activity

In order to identify novel proapoptotic genes, we screened approximately 1,000 hypothetical genes whose functions are completely unknown. After these genes were transiently expressed in HeLa cells, their nuclei images were captured using automated high-speed fluorescence microscope, through which the ratio of apoptotic nuclei was estimated. We selected genes that induce greater than 3-fold increase in apoptotic nuclei compared to that of the vector control. The candidate proapoptotic genes were sequenced and their effects on cell death were further confirmed by the additional assay, DNA fragmentation ELISA. Finally, we were able to identify 4 full-length hypo-thetical genes with proapoptotic activity.

Neuronal Cell Death in the Contralateral Hippocampus after Unilateral Hippocampal Kainic Acid-induced Seizure in Rats / 대한간질학회지

BACKGROUND: The recurrent temporal lobe epilepsy induces contralateral cell damage and secondary epileptogenesis in the contralateral hippocampus of rats. This phenomenon is fairly constant and has been used as a model of human temporal lobe epilepsy. It is necessary to understand this patho-mechanism in order to prevent this cell damage. METHODS: We have investigated the patho-mechanism of secondary epileptogenesis by using the rat model injected with kainic acid (KA) into the unilateral hippocampus. KA model shows initial complex partial seizures originating from the limbic structures and following convulsive status epilepticus. Immunohistochemical staining for c-fos expression, TUNEL stain for apoptosis, and hematoxylin-eosin (H-E) stain for morphologic changes were used. RESULTS: In the injected hippocampus, transient activation of c-fos was expressed in the dentate gyrus and CA3 hippocampal area, which were shaded out within 24 hours after the onset of limbic seizure. The stained cell with normal appearance was not observed in the H-E stain after 72 hours due to diffuse cell death. In the contralateral hippocampus, transient expression of c-fos was observed in the dentate gyrus, hilus, CA3, and CA1 area. But the expression of c-fos in the CA3 and CA1 area was sustained to 24 hours. Cell loss was mild in the CA3 and hilus, and mild cell degeneration and shrinkage were observed in the CA1 area. Apoptotic body was expressed in the CA1 area at 72 hours after the onset of seizure. CONCLUSION: These results mean that the area of prolonged expression of c-fos is vulnerable to apoptosis. Also it suggests that the patho-mechanism of ipsilateral hippocampus is an acute cytotoxic edema, whereas the contralateral damage is an apoptosis.

Two Cases of Refractory Status Epilepticus Treated with Ketamine / 대한간질학회지

Clinical observations and recent experimental studies have suggested that the longer status epilepticus (SE) persists, the more difficult it is to control SE pharmacologically. These findings imply that there are fundamental pathophysiologic processes, which make more resistant to intervene in the refractory SE. Recently, it has been recognized that ketamine, N-methyl-D-aspartate receptor antagonists, are effective agents in the treatment of the late stages of SE in the animal model. However, only one clinical experience has been reported. Here, we report two cases with refractory SE, responsive to ketamine.

An Autopsy Case of Pick's Disease

Pick's disease is a rare neurodegenerative disorder presenting cortical type of dementia. Pick's disease shows unique clinical and pathological features, that are due to a degeneration of fronto-temporal lobes of the cerebrum. The authors experienced a case of Pick's disease in a 58-year-old male patient who had dementia symptoms for five years. The patient showed compulsive behavior since five years ago. Memory decline started from four years ago and progressed. Brain CT disclosed lobar atrophy of the cerebral gyri in frontal and temporal lobes. He died of septicemia associated with aspiration pneumonia. At autopsy, both cerebral hemispheres showed marked encephalomalacia. The gyral atrophy was moderately severe in prefrontal and anterior temporal lobes. Coronal section disclosed moderate dilatation of the lateral ventricles. Microscopically, there were marked neuronal loss in prefrontal and anterior temporal cortices. Also noted were Pick's cells and Pick's body in occasional pyramidal cells preserved.

Central Hypoventilation Syndrome during Awake and Sleep

Central hypoventilation syndrome (CHS) can be caused by any lesions to the medullary respiratory centers, cerebral cortex, corticospinal pathways, and their connections. We report 5 patients with central hypoventilation syndrome and analyzed 26 patients who experienced central hypoventilation syndrome during sleep and waking states. We compared initial clinical symptoms and signs, maximal neurologic deficits, brain MRI and pathologic findings, and associated autonomic dysfunctions. The patients with respiratory failure during waking states showed quadriplegia, a rapidly progressing respiratory failure. The patients who had automatic respiratory failure showed mild hemiparesis, bulbar dysfunction, dysautonomia, and subacute to chronic recurrent respiratory failures. These results support the concept of two separate respiratory systems: a voluntary system and an automatic system. The respiratory management of these patients with central hypoventilation syndrome should be considered critical to their survival.

Blockade of the Subthalamo-nigral Pathway Prevents the Motor Component of Pilocarpine Induced Generalized Convulsive Seizure in Rats

BACKGROUND: The substantia nigra pars reticulata is a critical site for the control of epileptic seizures. The potentiation of the inhibitory gamma-amino butyric acid (GABA) ergic input from the striatum to the substantia nigra pars reticulata suppresses primary or secondary generalized seizures in rats. Recent data suggests that the projection from the subthala-mus to the substantia nigra pars reticulata plays a critical role in the control of some forms of epileptic seizures. METHODS: We examined the possible involvement of the excitatory glutamatergic input from the subthalamic nucleus (STN) to the substantia nigra in pilocarpine-induced seizures by the direct injection of GABA receptor agonist (muscimol) and n-methyl- D-aspartate (NMDA) receptor antagonist (MK-801) into the substantia nigra pars reticularis (SNr) and the subthalamic nucleus respectively. Sprague-Dawley rats were classified into four groups depending on the pretreatment; the injection of saline (STN sham) or muscimol (STN) into the subthalamic nucleus, and the injection of saline (SNr sham) or MK-801 (SNr) into the substantia nigra. Seizure was induced by the intraperitoneal injection of pilocarpine (400 mg/kg). RESULTS: Mean seizure stages in the STN group (1.5 +/-0.5) and SNr group (1.3 +/-0.5) were significantly lower than STN sham group (4.8 +/-0.4) and SNr sham group (4.8 +/-0.4) (P <0.05). Electroencephlograms showed typical status epilepticus patterns in the sham operation group but only discrete ictal discharges with slowing and intermittent ictal spikes were shown in both STN and SNr group. Viable cell numbers in the CA1 and CA3 in STN and SNr groups were significantly higher than those of the sham group (P <0.05). CONCLUSIONS: These results provide evidence for the role of subthalamo-nigral projections in the modulation of pilocarpine-induced seizures.

Subthalamic Lesion Protects Nigral Dopaminergic Neurons from 6-Hydroxydopamine-induced Cytotoxicity in the Rat Model of Early Parkinson's Disease

BACKGROUND: Subthalamic nucleus (STN) activity increases in patients and animal models of Parkinson's disease. It has been proposed that the STN may play a role in the progressive death of nigral dopamine (DA) neurons in PD. We studied the role of the excitatory afferents from the STN in the death of nigral DA neurons after a striatal 6-hydroxy-dopamine (6-OHDA) injection in a 6-OHDA-induced early Parkinson rat model. METHODS: Nigral DA neurons were counted using of tyrosine hydroxylase immunolabeling. Sprague-Dawley rats were subjected to unilateral, ibotenic acid-induced destruction of the STN 3 weeks after producing the early Parkinson model by injecting an intrastriatal 6- OHDA (8.75 microgram). Sham lesions of the STN were made by injecting phosphate-buffered saline. One week after STN ablation, lesions of nigrostriatal DA neurons were induced by repeated intrastriatal injections of 6-OHDA (8.75 microgram). RESULTS: Intrastriatal injections of 6-OHDA caused a progressive loss of nigral tyrosine hydroxylase-positive DA neurons in a dose dependent manner (3.5 microgram, 8.75 microgram, 17.5 microgram). The dose of 8.75 microgram of 6-OHDA was suitable for the early Parkinson model. Previous ablation of the STN significantly attenuated the loss of DA neurons in rats receiving 6-OHDA. Sham lesions of the STN did not affect DA neuron death induced by the toxin. CONCLUSIONS: The results indicate that excitatory inputs from the STN may contribute to the 6-OHDA-induced death of nigral DA neurons in the early state of Parkinson's disease.

Two Cases with Carbamazepine-induced Unusual Side Effects-Encephalopathy and Myoclonic Jerks

Central nervous system toxicity is the most commonly recognized problem during treatment with carbamazepine (CBZ). The most common side effects of CBZ are drowsiness, incoordination, and vertigo. However, unusual conditions such as movement disorders, seizure aggravation, and encephalopathy have also been attributed to CBZ therapy. In case 1, cognitive dysfunction and exacerbation of preexisting gait disturbance were observed in a 63-year-old female who had frontal lobe epilepsy, schizencephaly, and lissencephaly treated with CBZ. The neurological symptoms were resolved 24 hours after the withdrawal of CBZ and induced with the reintroduction of CBZ. In case 2, myoclonic jerks occurred in a 37-year-old female when CBZ was readministered after a 4-day-withdrawal period of CBZ. The myoclonic jerks disappeared 12 days after CBZ was discontinued. In both cases, plasma CBZ levels were within the therapeutic range. We report two cases with encephalopathy and myoclonic jerks as unusual side effects of CBZ, with the plasma levels of CBZ being within the therapeutic range.